Carol L. Elam

Comparing millennial and generation X medical students at one medical school.

Purpose Two main generational cohorts comprising students enrolled in medical schools today are Generation Xers (born 1965–1980) and Millennial students (born 1981–1999). A subset is Cuspars (born 1975–1980), who share traits with both generations. Population theorists ascribe different personal characteristics, attitudes, and preferences to each group. The authors examined whether selected characteristics describing Generation X and Millennial students were quantifiable using a personality measure. Differences among Generation X, Millennial, and Cuspar medical students were investigated. Method Eight hundred and nine medical students (399 females and 410 males) who matriculated between 1989–94 and 2001–04 at the Northeastern Ohio Universities College of Medicine completed the 16 Personality Factor Questionnaire (16PF). Differences in responses to the 16PF among the three generations were analyzed using multivariate analysis of variance (MANOVA). Results Analyses showed significant differences for Generation X versus Millennial students on 10 of the 16 personality factors. Millennial students scored significantly higher than Generation X students on factors including Rule-Consciousness, Emotional Stability, and Perfectionism; Generation X students scored higher than Millennials on Self-Reliance. Millennials also were significantly different from Generation Xers on several other factors. Significant differences were noted among Cuspars, Generation Xers, and Millennials. Conclusions The 16PF is a useful tool to examine differences among these groups and to help understand the factors that constitute their personalities. Given differences among the generational groups, the authors forecast possible educational implications for medical school academic affairs and student services, and suggest areas for future research.

Emotional intelligence and clinical skills: preliminary results from a comprehensive clinical performance examination.

Background The recognition of emotional states in one’s self and others, emotional intelligence (EI) may play a key role in patient care. This study examines the relationship between EI and students’ clinical skills in a required, comprehensive performance examination (CPX). Method Prior to taking a 12-station CPX, third-year students in 2003 and 2004 (n = 165) completed the Trait Meta-Mood Scale and Davis’ Interpersonal Reactivity Index. Dimensional subscales were computed and correlated with selected aspects of students’ clinical skills as recorded by standardized patients in each objective structured clinical examination (OSCE)-type encounter. Results The internal consistencies (&agr;) of subtests ranged from .73-.90. Attention to Feelings, Empathic Concern, and Perspective Taking were significantly (p = ≪ .05) positively correlated with communication skills, while the latter two were also significantly negatively associated with physical examination skills. Conclusions Various aspects of EI are modestly implicated in students’ clinical skills as assessed by standardized patients in an OSCE.

Differences in motives between Millennial and Generation X medical students.

Medical Education 2010: 44: 570–576

The Effect of Gender and Age on Medical School Performance: An Important Interaction

Being able to predict medical school performance is essential to help ensure the supply of quality physicians. The purpose of our study was to examine the influence of gender and age on academic performance (AP) and on academic difficulty (AD). The study involved all matriculants of 3 classes at one medical school. Independent variables included gender, age (categorized into younger and older than 23 years) and the gender by age interaction. Dependent variables included an AP scales core, a clinically based performance examination and AD. The Wilson AP Scale score was developed to assess both excellent and poor performance. The Wilson AP Scale included first-, second-, and third-year medical school grade-point-averages, USMLE Step 1score and USMLE Step 2 score. Older women as a group had the highest mean Wilson AP Scale score. Women performed better than men on the clinically based performance examinations. Younger men were least likely to have AD and younger women were most likely to have AD. Five of 123 younger men versus 13/66 older men had AD. Also, 15/63 younger women had AD versus 2/27 older women. A significant gender by age interaction was present in predicting the Wilson AP Scale score (p =0.009) and AD (p = 0.002). Older women performed better than both older men and younger women in 3 classes of medical students at one medical school. A significant gender by age interaction was predictive of AP and AD. These findings may have implications on admission decisions.

Service Learning in the Medical Curriculum: Developing and Evaluating an Elective Experience.

Background: Medical educators are seeking ways to nurture the service commitments of their medical students while promoting interactions with the communities they serve. Service learning is a pedagogy that links community service with academic experience. Description: The University of Kentucky College of Medicine has developed and implemented an experiential service learning elective. The elective is based in local community agencies where small groups of students perform an asset-needs assessment and design a service project based on their findings. The elective is linked to a behavioral science course that provides accompanying biopsychosocial instruction. Evaluation: Over the 2-year project period, we used multiple methods (i.e., surveys, interviews, reflection questionnaires, evaluations of student performance, and course evaluations) to gather information on the motivations, observations, and assessments of students, faculty preceptors, and community agency partners. Conclusion: Linking a service learning elective to a pre-existing course worked well, achieved its objectives, and will be continued.

Interprofessional education in US medical schools

IntroductionInterprofessional education (IPE) is called for in United States health professionseducation (Institute of Medicine, 2003). The Association of American Medical Colleges(AAMC) includes interprofessional health education and practice as a strategic area inwhich the organization and members should engage (AAMC, 2007). The current statusof IPE within United States medical schools has remained largely unexamined.Therefore, we sought to learn the current practice of IPE in US medical schools,including program features, institutional governance and resource contexts, and barriersto implementation.MethodsWe surveyed college of medicine education deans or dean designees of 126 US medicalschools as identified by the AAMC in late summer, 2008, using an instrument we developedfollowing a literature review. The instrument was composed of three sections: (1) adescription of specific IPE offerings at the school, (2) information regarding institutionalsupports and IPE resources, and (3) perceptions of potential barriers to IPE. With respect tothe description of specific IPE offerings, respondents were asked the following: (a) if offeringwas required or elective, (b) learner disciplines involved, (c) faculty disciplines involved, (d)type of learning experience, (e) type of learning setting, (f) general content area of offering,and (g) student assessment methods. With respect to institutional supports and resourcesfor IPE, respondents were asked the following: (a) administrative unit with responsibility forcoordinating IPE, (b) budget for IPE, (c) governance of IPE, (d) resources (monetary and

Emotional intelligence and medical specialty choice : findings from three empirical studies

Context  Despite only modest evidence linking personality‐type variables to medical specialty choice, stereotypes involving empathy and ‘emotional connectedness’ persist, especially between primary care providers and surgeons or subspecialists. This paper examines emotional intelligence (EI) and specialty choice among students at three US medical schools.

Measuring the emotional intelligence of medical school matriculants.

507 and professionalism during the first semester, using lectures, small groups, communication labs, and interactions with standardized patients. Within the first few weeks, the students and faculty complete the Emotional Quotient Inventory (EQi) developed by Bar-On, listen to one lecture on emotional intelligence, and subsequently receive personal EQi results, which are distributed at a small-group session. The faculty tutors share personal interpretations and reflections on their own scores and permit the students, if they so choose, to discuss their own scores in a safe setting. The focus on professionalism continues throughout the two-year course with additional small-group sessions and standardizedpatient experiences promoting the ideas of self-reflection and growth. Plans are to readminister the EQi in the students’ second and third years. Discussion: Most students are selected into medical school based on history of academic and cognitive successes, yet each possesses a unique emotional make-up that reflects personal life experience, coping skills, and core values and beliefs. To be able to practice medicine, the student must have the ability to understand the views and needs of a wide variety of people, remain sensitive and empathic to patient concerns, and be able to keep his or her personal emotional reactions in perspective, handle stress, and promote social responsibility—all concepts that the EQi attempts to measure. We believe the first step is for students to examine and understand their own emotional intelligence, which will, if developed, assist them in the ability to identify and accept the views of their patients. This process has long been expected to occur on its own through the hidden curriculum of medical education and the presence of excellent role models. Use of the EQi will formalize this process, will direct both faculty and students to utilize opportunities to become skilled in the physician–patient interaction, and will provide a means for assessment of intrapersonal change. Inquiries: Peggy J. Wagner, PhD, Department of Family Medicine, HB3040, Medical College of Georgia, August, GA 30912-3500.

An Admission Model for Medical Schools.

Complex societal issues affect medical education and thus require new approaches from medical school admission officers. One of these issues—the recognition that the attributes of good doctors include character qualities such as compassion, altruism, respect, and integrity—has resulted in the recent focus on the greater use of qualitative variables, such as those just stated, for selected candidates. In addition, more emphasis is now being placed on teaching and licensure testing of the attributes of the profession during the four-year curriculum. The second and more contentious issue concerns the system used to admit white and minority applicants. Emphasizing character qualities of physicians in the admission criteria and selection process involves a paradigm shift that could serve to resolve both issues. To make this or any paradigm shift in admission policy, medical schools must think about all the elements of admission and their interrelationships. A model of medical school admission is proposed that can provide understanding of the admission system and serve as a heuristic guide. This model consists of (1) the applicant pool; (2) criteria for selection; (3) the admission committee; (4) selection processes and policies; and (5) outcomes. Each of these dimensions and the interrelationships among the dimensions are described. Finally, a hypothetical example is provided in which the model is used to help a medical school change its admission process to accommodate a new emphasis in the schools mission.

Does institutional selectivity aid in the prediction of medical school performance

Various factors are considered in the decision to offer an admission interview to a medical school applicant, including Medical College Admission Test (MCAT) scores, undergraduate grade-point average (GPA), and the selectivity of the degree-granting undergraduate institution. Admission officers view MCAT scores, undergraduate GPA, and institutional selectivity as having high or moderate importance. Research has indicated that these factors, most notably the MCAT scores and the undergraduate GPA, are reliable in helping predict medical school performance. The strongest association has been shown between MCAT scores and performance on the United States Medical Licensing Examination, Step 1. Institutional selectivity data are used to help control for differences in grading stringency across undergraduate institutions. Previous reports have examined the role of institutional selectivity, or a specific undergraduate institution, as a predictor of performance in the first two years of medical school. With the exception of the study of Zelesnik et al., which examined ten specific undergraduate institutions, these reports have used the Higher Education Research Institute (HERI) Index, also called the ‘‘Astin Index,’’ as a measure of institutional selectivity. Other measures of institutional selectivity or categorization that schools of medicine may employ include the Barron’s Profiles of American Colleges Admissions Selector Rating and the Carnegie Classification from the Carnegie Foundation for the Advancement of Teaching. (These measures are explained in the next section.) Institutional validity studies of admission decision-making data help to determine which characteristics should be accorded highest importance in applicant selection. Given the reliance upon institutional selectivity as an important admission characteristic and the different types of selectivity classifications available for medical schools to use, the purpose of this study was to examine how well three measures of institutional selectivity could predict medical students’ performances, specifically their performances on the USMLE Step 1 and Step 2 and their final medical school GPAs.